It has been reported that pancreatic carcinoma involves an average of 63 genetic alterations mainly related to 12 cellular signalling pathways [8] and that the genetic lesions arise through activating mutations of KRAS and inactivation of the INK4A, p53-ARF and SMAD4 pathways [9–11]. Here, SMAD4 is linked to exocrine pancreatic carcinoma.